Provider Demographics
NPI:1154094613
Name:ENCHANTMENT HEALTHCARE PARTNERS LLC
Entity Type:Organization
Organization Name:ENCHANTMENT HEALTHCARE PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:NENGAH
Authorized Official - Last Name:NKWENTI
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:505-881-4500
Mailing Address - Street 1:3500 COMANCHE RD NE BLDG E STE 1
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4546
Mailing Address - Country:US
Mailing Address - Phone:505-881-4500
Mailing Address - Fax:505-881-5158
Practice Address - Street 1:3500 COMANCHE RD NE BLDG E
Practice Address - Street 2:SUITE E
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4546
Practice Address - Country:US
Practice Address - Phone:505-881-4500
Practice Address - Fax:505-881-5158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty